The infection-prevention nurse observes central venous catheter dressing care. Which actions require follow-up? Highlight the practices that can increase catheter-related infection risk.
Highlight in Table
Choose your responses, then check the answer.
Explanation
Follow up when a loose dressing remains, the prepared site is touched with a nonsterile glove, ointment is applied to a nondialysis site, or old gloves are reused. Central-line care requires hand hygiene, appropriate antisepsis, and a sterile intact dressing.
Quick answer Correct the loose dressing left in place, nonsterile palpation after skin antisepsis, topical antibiotic ointment on a nondialysis central-line site, and reuse of contaminated gloves for the clean dressing step.
Why this is correct A central-line insertion site needs an intact sterile dressing and aseptic handling. Hand hygiene is required before and after catheter care, antiseptic should dry, and a damp, loose, or soiled dressing should be replaced. Routine topical antibiotic ointment is avoided at nondialysis sites, and clean or sterile gloves used for the new dressing should not be the contaminated pair used to remove the old one.[2]
Easy analogy or mental picture Think of the dressing as a sealed roof over a doorway into the bloodstream. A loose roof, a contaminated touch, or reused gloves creates a path for organisms. The roof analogy does not replace the exact dressing material and interval specified by the catheter and facility policy.
NCLEX decision rule For invasive-line care, trace every action that crosses from dirty to clean. If sterility is broken or the barrier is loose, wet, or soiled, stop and restore the aseptic barrier rather than covering or ignoring the break.
Why the other choices are wrong Hand hygiene, allowing chlorhexidine-alcohol to dry, applying a sterile transparent dressing, protecting the site from shower water, and disinfecting the hub follow infection-prevention principles in the displayed situation.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
CDC: Intravascular Catheter Infection Prevention RecommendationsCenters for Disease Control and Prevention